Low weight at birth can be an indicative in childhood as a marker of metabolic syndrome and hypertension

As low weight at birth can be a marker for future risk factors for cardiovascular diseases, public school children who had this positive history were studied S to nutritional status, lipids, glucose, uric acid, blood pressure and socioeconomic conditions. The main interest of the investigation is to find statistically significant correlations among data collected from young public school children from a city outside of the capital of Sao Paulo in Brazil. Results: risk factors for metabolic syndrome presented higher impact considering blood pressure and socioeconomic conditions, calling for better prenatal care and surveillance plus intervention in the low weight at birth children.

The effects of physical inactivity

Physical inactivity constitutes the basis of diseases that reduce life duration and quality and rank first among the causes of death in the world. Worldwide, it has been determined that 23 % of adults aged 18 and over are not active enough. According to the World Health Organization, sedentary life is among the main risk factors for deaths from non-communicable diseases worldwide and causes approximately 3.2 million deaths per year. For this reason, the issue of reducing inactivity has gained importance in the world today. As a solution, it is thought that increasing physical activity requires not only individual but also community-specific, multi-sectoral, multi-disciplinary and culturally appropriate approaches.

A primer on hypertension and on the racial / ethnic disparities in diagnosis and management: a comprehensive overview

Hypertension is a major cause of premature death worldwide, where it contributes to stroke, cardiovascular and renal disease. Forty percent of adults aged 30-79 years worldwide have hypertension, two-thirds of whom are living in low and middle-income countries. Most adults with hypertension are not fully aware that they have the condition, therefore it often goes ignored and untreated. Of the 1.28 billion people worldwide, who have been reported to have hypertension, data indicates that one in five females and one in four males are included in that estimate. Moreover, data from World Health Organization reports that less than half of adults (42%) with hypertension are diagnosed and treated adequately and approximately only one in five adults (21%) with hypertension have it under adequate control. One of the worldwide goals for non-communicable diseases is to scale back the prevalence of hypertension by 33% between 2010 and 2030. In African Americans, readily available thiazide diuretics or Calcium Channel Blockers (CCBs) have been shown to be more effective in lowering blood pressure than Renin Angiotensin System inhibitors (RAS) or β-adrenergic blockers and are also more effective in reducing cardiovascular disease (CVD) events than RAS inhibitors or adrenergic blockers. The ethnical difference in hypertension and hypertension- related complaint issues are associated with lesser mortality and morbidity pitfalls compared with their white counterparts. These redundant pitfalls from elevated blood pressure have a dramatic effect on life expectancy and career productivity for African American men and women and which is significantly lower than has been reported for Caucasian Americans of either gender. These present challenges remain to be completely understood and give a result to overcome ethnical and racial differences in the frequency and treatment of hypertension. Social determinants of health similar as educational status, access to health care and low income play a crucial part in frequency and blood pressure control rates. Development of appropriate health care programs at the state and public situations to address these issues will be essential to reduce these differences. Thus, the purpose of this paper is to review the prevalence and ethnic disparities in the diagnosis and treatment of hypertension and to suggest steps to improve the outcomes.

A cross-sectional study to assess the cause of present suicide attempt and socio-demographic profile among the suicide attemptees in a tertiary care centre, Bengaluru

Context: A high suicide rate is an index of social disorganization. In India, it is the second leading cause of death among 15-29 years age group. Young age, female sex, poor education, unemployment and socio economic deprivation are some of the potential risk factors. Aim: To assess the cause of present suicide intent and socio-demographic profile in patients with attempted suicide in a tertiary care centre. Settings and design: Study setting in tertiary care centre, Bengaluru and a Cross-sectional study design. Methods and material: A Cross Sectional Study was conducted among 476 suicide attempted patients by Convenient sampling from January 2016 to May 2017. Data was collected by using a pretested, semi-structured questionnaire. Statistical analysis: Descriptive statistics and inferential statistics if required. Results: Mean age of study participants was 30.65+0.75 years. Most of the suicide victims (82.97%) were from nuclear families.24.57%of study participants had family history of suicide.49.66% of them had a suicidal intent during the past 12 months and only 26.89% of them sought professional help. Conclusion: Suicides and attempted suicides are slowly but steadily assuming the levels of a public health problem caused by multiple factors. Hence there is a need to address the risk factors for suicide attempts and preventing them by taking proper measures at individual, family and societal level.

Educational spaces and environments: in times of Covid-19 pandemic

The appearance of COVID-19 brought to Brazil, and to the world, innumerable methods to contain the increase of infected people. These methods are necessary to avoid the spread of the virus and include social distancing and quarantine of the population. Knowing that these methods have a big impact on the educational system. This study has as its objective to verify the process of teaching and learning, in educational spaces and environments, in times of a pandemic. In order to look for a pattern in established actions in educational programs to incorporate in large scale the tools of educational technology at a distance (distance learning), for example platforms and virtual teaching environments designed to guarantee the pedagogical processes of learning and ameliorate the impact of absence from the classroom during the pandemic, and its post-pandemic consequences. We emphasize the importance of the teacher as mediator, understanding that this professional should respect the different levels of learning of the students and try to carry out activities that help with the improvement of practical education for the appropriate environment and spaces of interaction.

Midwives’ knowledge of COVID 19 and pregnancy in four maternity units in Brazzaville in 2021

Purpose: To evaluate midwives' knowledge of Covid 19 and Pregnancy. Materials and methods: This was a knowledge analytical study. Midwives working in delivery units and outpatient clinics were included. The variables were focused on socio-demographic and professional aspects, general information on Covid-19, the clinical and biological manifestations, the prevention of corona virus transmission and the prevention of mother-to-child transmission. Results: Out of 82 respondents, 73 (89.1%) were secondary school graduates, working mainly in Talangai Hospital. The media was the source of information for 78 (95.1%); Covid 19 is a viral infection 78 (95.1%); the route of contamination was respiratory 79 (96.3%) and transplacental 16 (19.5%) of respondents. The clinical signs were: fever 76 (92.7%), cough 77 (93.9%) and dyspnea 77 (93.9%) of the respondents. Biological diagnosis was done by RDT (rapid diagnosis test) 73 (89, 1%), completed by PCR confirmation 43 (52.4%) of the respondents. Prevention methods: hand washing several times a day 72 (87,8%) and alternative by disinfectant gel 75 (91,5%); lifting the fold of the elbow when sneezing or coughing 76 (89%); used handkerchief thrown in the trash 70 (85,4%) of the respondents; out of 3 preventive measures in the labour room, 20 (23,4%) answered correctly, 48 (58,5%) gave only 1 to 2 correct answers and 14 (17%) did not identify any measure. The overall knowledge of midwives on Covid 19 was insufficient 25 (30.5%), average 52 (63.4%), good 5 (6.1%) of the respondents. For the factors that can influence the level of knowledge, there is no link between the level of knowledge and the socio-professional characteristics of the midwives (Chi2 test: P-value ˃ 5%). However, the fact of working at the CHUB could have a slight influence (sensitive P-value close to 95%). Conclusion: There is a need to diversify sources of information for an improvement of knowledge in order to place the midwife at the top of the medical news.

Visceral pseudoaneurysms and the role of endovascular treatment – a case report

Introduction: Visceral pseudoaneurysms are pathological dilations of the visceral arteries and/or their branches. They are a rare entity but with devastating consequences given their high potential for rupture and hemorrhage. The evolution of endovascular techniques has changed the paradigm in the treatment of this entity, making it the preferred option for the elective treatment of visceral pseudoaneurysms. Clinical case: The authors described the case of a pancreatic pseudoaneurysm in a young male patient, with past medical history of chronic pancreatitis and pancreatic pseudocyst, marked smoking and alcoholic habits, which presented with an abdominal pain and a drop in hemoglobin. After discussing the case with the Vascular Surgery department, it was decided towards an endovascular treatment given the patient's clinical stability and appropriate anatomical location for the proposed intervention. Coil embolization via humeral artery was performed with immediate angiographic success, and clinical, analytical and imaging improvement in the postoperative period. Conclusion: In addition to open surgical repair and laparoscopic surgery, there are also endovascular procedures for the treatment of visceral pseudoaneurysms, so the vascular surgeon must be aware with the available strategies, taking into account the patient, the characteristics and location of the visceral pseudoaneurysm.

Risk of work addiction in academic physicians prevalence, determinants and impact on quality of life

The prevalence of work addiction is constantly increasing worldwide, ranging from 8.3% to 30%, especially among physicians. The aim of this study was to assess the prevalence and characteristics of Work Addiction among academic physicians and its influence on their mental and physical health. This is a cross-sectional survey conducted among the 293 academic physicians practicing in the teaching hospitals of the faculty of Medicine of Monastir in Tunisia. We used a self-administered questionnaire, with the «Work Addiction Risk Test » and the «SF-8 health survey». The participation rate was 24.3%, 24% were addicted to work and 56% were at high risk of addiction. WART score was significantly higher in single, females with medical history of depression or associated depression, poor physical and mental health and psychosomatic symptoms. It was significantly decreased with age, and seniority. Certain psychosocial factors increased WART score. Mental health score was significantly lower in single, females, assistant professor and increased with age, seniority and number of children. Academic physicians are at a high risk of developing work addiction. Preventive guided measures to reconcile family life and work as well as organizational strategies are recommended.

Surgical therapy for herlyn-werner-wunderlich (HWW) syndrome cases

Introduction: One of the rare forms of Mullerian congenital ducts is Herlyn-Werner-Wunderlich (HWW) syndrome. HWW syndrome is usually found at puberty with nonspecific symptoms. Pelvic pain can be found both acute and chronic, dysmenorrhoea, as well as hematometra and hematocolpos. Early detection and treatment results in a good prognosis with fertility preservation. Case presentation: Two cases of Herlyn-Werner-Wunderlich (HWW) syndrome surgically performed were reported at Dr. Sardjito Yogyakarta Indonesia Central General Hospital in 2017-2018. Both cases are still children and at the age of puberty. The chief complaint in both cases it was reported to have the same main complaint, abdominal pain, with the condition having never experienced menstruation yet. On further examination it is known that pain is caused due to hematometra and hematosalping that occur in both cases. The first case with hematometra in the right hemiuterus and right hematosalpinx, while second case with hematometra in the uterus didelphys and bilateral hematosalpinx. One case with a normal vagina, and the other case of vaginal agenesis. There was previous history of surgery in both of cases. There are abnormalities in the urinary tract that occur together with these genital abnormalities. Surgical therapy is carried out with the main goal being to drain menstrual blood from hematometra and hematosalpinx. In first case which has a vagina within the normal range (9 cm long) and the inferior area of ​​the right hemiuterus which is bulging toward the vagina, an area can be identified for the drainage incision to drain the entire hematometra and hematosalpinx. In the second case with vaginal agenesis, neovagina which is made by sigmoid colon vaginoplasty surgery can be a way of menstrual blood flow for a lifetime. Conclusion: Clinical manifestations of Herlyn-Werner-Wunderlich (HWW) syndrome cases can be classified into 2 groups, complete and incomplete. Surgical treatment is based on the condition of the uterus and vagina. In the condition of cervical agenesis but with a normal vagina, surgery can be done by making an incision in the drainage of the uterine cervical tissue. If vaginal agenesis is obtained, vaginoplasty surgery can be performed, and one of the options is sigmoid colon vaginoplasty.

Pulmonary histoplasmosis: A case report

Histoplasmosis is a systemic fungal infection caused by dimorphic fungus Histoplasma capsulatum. It is widely distributed throughout the world. In present study, the case of a 50-year-old male patient diagnosed as pulmonary histoplasmosis. Initially, the patient was suspected as a case of alcoholic hepatitis but subsequently the diagnosis of pulmonary histoplasmosis was confirmed by lung biopsy. The symptoms were dissuaded following amphotericin B and itraconazole treatment.